Blindsided

"We thought our health insurance had us covered."

Gambling on the Future

Julie Weeks, 33, always wanted a porch. So her husband, Wes, a man born with a tool belt strapped to his waist, built the oasis Julie dreamed of with his own hands. The shady space at the front of their home soon became a favorite spot for the couple and their eight-year-old daughter, Amanda, to catch a breeze and escape the late-day sun over Long Beach, California.

But then one morning in April 2002, Wes, 37, awoke at 5 a.m. with a headache. "Try to go back to sleep," Julie said. "I'll wake you in a half-hour." She knew he liked to get an early start on the many details it took to run his successful business installing kitchen and bathroom tile. Moments later, though, Wes began to moan, his legs flailed and his eyes became glassy. Suddenly he rolled onto his back and vomited.

Julie called 911, but the firefighters and paramedics who arrived mistakenly thought the sluggish, unresponsive young man was either high on drugs or drunk. The hospital's emergency room physician agreed.

Finally, at 10 a.m. -- five hours after Wes's strange symptoms began -- a physician studied his CAT scan and discovered the devastating truth: Wes had suffered a massive stroke. A blood clot had formed in a carotid artery, preventing oxygen from reaching the left side of his brain.

Later that day, Wes lay motionless on a bed while a brusque neurologist examined him. Julie felt numb as the doctor snapped, "He may get better, he may not. But the chances are this is how he's going to be the rest of his life -- if he lives."

Wes's condition improved somewhat in the two months he spent in the hospital. Before he returned home, though, an insurance-company case manager contacted Julie with more bad news: Their policy would cover only a fraction of Wes's future medical expenses.

The Weekses had selected a health insurance plan through a broker, who steered the young, healthy couple to a policy with premiums under $200 a month that allowed two office visits and a maximum of $1,000 in prescription drugs per year. "It's perfect for you," the broker said.

Now, as a result of the stroke, Wes would need to see doctors several times a month and take a handful of pills every day. They had gambled on their health and financial future -- and lost.

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